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Calvo, Maria J.Author

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June 8, 2017
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Effectiveness of the WC/rBS oral cholera vaccine in the prevention of traveler's diarrhea A prospective cohort study

Publicated to:Human Vaccines & Immunotherapeutics. 9 (3): 692-698 - 2013-01-01 9(3), DOI: 10.4161/hv.23267

Authors: Lopez-Gigosos, Rosa; Campins, Magda; Calvo, Maria J.; Perez-Hoyos, Santiago; Diez-Domingo, Javier; Salleras, Luis; Azuara, Maria T.; Martinez, Xavier; Bayas, Jose M.; Ramon Torrell, Josep M.; Perez-Cobaleda, Maria A.; Nunez-Torron, Maria E.; Gorgojo, Lydia; Garcia-Rodriguez, Magdalena; Diez-Diaz, Rosa; Armadans, Luis; Sanchez-Fernandez, Concepcion; Mejias, Teresa; Masuet, Cristina; Pinilla, Rafael; Anton, Nieves; Segarra, Pilar;

Affiliations

Ctr Publ Hlth Res, Valencia, Spain - Author
Hosp Valle De Hebron, Barcelona, Spain      Hospital Universitari Vall d'Hebron       - Author
IVC Consorcio Hosp Gen Univ Valencia, Valencia, Spain - Author
IVC Hosp Bellvitge, Barcelona, Spain       - Author
IVC Hosp Clin, Barcelona, Spain       - Author
IVC Madrid, Madrid, Spain       - Author
IVC Vigo, Pontevedra, Spain       - Author
IVC, La Coruna, Spain       - Author
IVC, Malaga, Spain - Author
IVC, Santander, Spain       - Author
IVC, Valencia, Spain       - Author
Univ Barcelona, Barcelona, Spain      University of Barcelona       - Author
       - Author
      IVC, Malaga, Spain. - Author
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Abstract

Traveler's diarrhea (TD) is the most frequent disease among people from industrialized countries who travel to less developed ones, especially sub-Saharan Africa, Southern Asia and South America. The most common bacteria causing TD is enterotoxigenic Escherichia coli (ETEC). The WC/rBS cholera vaccine (Dukoral) has been shown to induce cross-protection against ETEC by means of the B subunit of the cholera toxin. The aim of the study was to evaluate the effectiveness of the WC/rBS cholera vaccine in preventing TD.Between May 1 and September 30 (2007), people seeking pre-travel advice in ten Spanish international vaccination centers were included in a prospective cohort study of travelers to cholera risk countries. The incidence rates of TD were adjusted for variables whose frequencies were statistically different (entry point 0.10) between the vaccinated and non-vaccinated cohorts.The vaccinated cohort (n = 544 travelers) included people vaccinated with the WC/rBS cholera vaccine, and the non-vaccinated cohort (n = 530 travelers) by people not vaccinated. The cumulative incidence rate of TD was 1.69 in vaccinated and 2.14 in non-vaccinated subjects. The adjusted relative risk of TD in vaccinated travelers was 0.72 (95% CI: 0.58-0.88) and the adjusted vaccination effectiveness was 28% (95% CI: 12-42).The WC/rBS cholera vaccine prevents TD in 2 out of 7 travelers (preventive fraction: 28%). The number needed to vaccinate (NNV) to prevent 1 case of TD is 10.

Keywords

choleraeffectivenessnumber needed to vaccinatetraveler's diarrheawc/rbs vaccineBangladeshCholeraEffectivenessEpidemiologyEscherichia-coliEtecEtiologyField trialNumber needed to vaccinatePreventive fractionTraveler's diarrheaWc/rbs vaccine

Quality index

Bibliometric impact. Analysis of the contribution and dissemination channel

The work has been published in the journal Human Vaccines & Immunotherapeutics due to its progression and the good impact it has achieved in recent years, according to the agency WoS (JCR), it has become a reference in its field. In the year of publication of the work, 2013, it was in position 82/165, thus managing to position itself as a Q2 (Segundo Cuartil), in the category Biotechnology & Applied Microbiology. Notably, the journal is positioned en el Cuartil Q2 para la agencia Scopus (SJR) en la categoría Medicine (Miscellaneous).

From a relative perspective, and based on the normalized impact indicator calculated from the Field Citation Ratio (FCR) of the Dimensions source, it yields a value of: 4.49, which indicates that, compared to works in the same discipline and in the same year of publication, it ranks as a work cited above average. (source consulted: Dimensions Jul 2025)

Specifically, and according to different indexing agencies, this work has accumulated citations as of 2025-07-21, the following number of citations:

  • WoS: 17
  • Scopus: 20
  • Europe PMC: 13

Impact and social visibility

From the perspective of influence or social adoption, and based on metrics associated with mentions and interactions provided by agencies specializing in calculating the so-called "Alternative or Social Metrics," we can highlight as of 2025-07-21:

  • The use of this contribution in bookmarks, code forks, additions to favorite lists for recurrent reading, as well as general views, indicates that someone is using the publication as a basis for their current work. This may be a notable indicator of future more formal and academic citations. This claim is supported by the result of the "Capture" indicator, which yields a total of: 98 (PlumX).

It is essential to present evidence supporting full alignment with institutional principles and guidelines on Open Science and the Conservation and Dissemination of Intellectual Heritage. A clear example of this is:

  • The work has been submitted to a journal whose editorial policy allows open Open Access publication.